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Author Topic: 4 week viral load  (Read 10287 times)

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Offline brie41

  • Member
  • Posts: 191
4 week viral load
« on: April 04, 2016, 07:16:23 pm »
Hi Everyone,

  Well it has been 3 weeks since I started on Harvoni and it is going great.  I can't complain.  The few mild side effects that I had seem to be gone!!  I do however have a question about my 4 week viral load.  My Doctor said I need to come into the office to get my results in case they are bad??  I feel like they should be able to tell me this over the phone, but I will go along with it.  I did however ask if they will fight for me to get 4 more weeks if that was the case, but I didn't really get an answer.   So if I am not undetected at 4 weeks, should I press the issue to continue to 12 weeks?  Also, what would be considered bad news at 4 weeks??   The anxiety never stops!!!  Brie
Diagnosed  HCV, 1A 2006
Viral load 6 million
Ast/Alt always in the 20's
F0-F1, never changed
Treatment naive, started 8 week Harvoni 3/15/16
4 and 8 week labs undetected
6 week eot labs undetected
13 week eot UNDETECTED!

Offline Lynn K

  • Global Moderator
  • Member
  • Posts: 4,543
  • Get tested, get treated, get cured, fight Hep c!
Re: 4 week viral load
« Reply #1 on: April 04, 2016, 09:34:24 pm »
Bad news at 4 weeks would be no decrease in viral load but that would only happen if you were not taking your meds so it is more for your doctor to confirm compliance with treatment.

On treatment viral load testing means little to eventual SVR. Likely they would just want to counsel you if you are weakly detected instead of just dropping that news in an email with out explanation of the meaning of your result sounds like you have a nice doctor.

The only test that matters is the 12 week post test.

Results for treatment naive GT1 patients treated for 8 weeks in the ION-3 clinical trial  was an SVR 12 rate of 94%

If you are still weakly detected you could try to ask your doctor and insurance about increasing treatment duration to 12 weeks but it is questionable they would approve.

We even had a few folks here who were weakly detected at EOT but went on to achieve not detected and SVR 12.

We all are or were anxious about being successful on treatment. Just try to breath and remember the odds are very much on your side you will beat this thing.

Good luck
Genotype 1a
1978 contracted, 1990 Dx
1995 Intron A failed
2001 Interferon Riba null response
2003 Pegintron Riba trial med null response
2008 F4 Cirrhosis Bx
2014 12 week Sov/Oly relapse
10/14 fibroscan 27 PLT 96
2014 24 weeks Harvoni 15 weeks Riba
5/4/15 EOT not detected, ALT 21, AST 20
4 week post not detected, ALT 26, AST 28
12 week post NOT DETECTED (07/27/15)
ALT 29, AST 27 PLT 92
24 week post NOT DETECTED! (10/19/15)
44 weeks (3/11/16)  fibroscan 33, PLT 111, HCV NOT DETECTED!
I AM FREE!

Offline brie41

  • Member
  • Posts: 191
Re: 4 week viral load
« Reply #2 on: April 05, 2016, 07:46:21 am »
Hi Lynn,

  Thank you for the clarification.   That makes me feel better!!  I know we are all in limbo, but the odds are in our favor for sure.   Have a nice day!  Brie
Diagnosed  HCV, 1A 2006
Viral load 6 million
Ast/Alt always in the 20's
F0-F1, never changed
Treatment naive, started 8 week Harvoni 3/15/16
4 and 8 week labs undetected
6 week eot labs undetected
13 week eot UNDETECTED!

Offline BillT

  • Member
  • Posts: 573
Re: 4 week viral load
« Reply #3 on: April 05, 2016, 10:11:33 am »
Hi Brei,
          Hopefully your results will be great.I've noticed there were several that still showed a little VL at the 4 week point but it had dropped tremendously.Don't let it worry you if it does show a bit.As Lynn said many showed a bit even at EOT and went on to SVR.When you go see your doctor have the discussion then about getting the other 4 weeks.I'm not one that stresses easily but this time it was bad so I understand.We go through so much,and this means so much to us it's unavoidable.Let us know what happens and best of luck to you. 
Contracted 1973 Military
Diagnosed 1980
Pegintron treatment 2004 unsucessful
Genotype 1b
FibroScan 10 (F2)
Start Viekira 10.17.2015

AST 40 ALT 69
VL 440k
10.31.2015/Week 2 Labs : AST 14/ALT 17
No VL done
10.14.2015/Week 4 labs : AST 14/ALT 14
VL UNDETECTED!!!
12.11.2015/Week 8 Labs : AST 12/ALT 13
No VL done
01.05.2016/EOT labs : AST 15/ALT 13
VL UNDETECTED!!!

12 WEEK SRV:UN-BLOODY DETECTABLE !!!!!!!!

24 WEEK SVR:UNDETECTABLE!!!! Thank You God.

Fibroscan 6Mo. Post Treatment 7.15.2016-5.3(F1)

Offline brie41

  • Member
  • Posts: 191
Re: 4 week viral load
« Reply #4 on: April 05, 2016, 06:56:16 pm »
Hi Bill,

  Thank you for your input.  It is easy to stress about the end result but it does not change the reality I guess.  I am ready to fight for another 4 weeks if I am not undetectable or really close to it.  I will keep you posted!!  Brie
Diagnosed  HCV, 1A 2006
Viral load 6 million
Ast/Alt always in the 20's
F0-F1, never changed
Treatment naive, started 8 week Harvoni 3/15/16
4 and 8 week labs undetected
6 week eot labs undetected
13 week eot UNDETECTED!

Offline FutureThinker

  • Member
  • Posts: 711
  • Onward and upward!
Re: 4 week viral load
« Reply #5 on: April 06, 2016, 08:44:56 pm »
Hi Brie41, I'm one who was still detected at 4 weeks (30 down from 3 mil), which of course did not make me happy.  So I read some more on VL testing, and while I would have preferred to see that magic word "undetected", from my reading and my doctor, the 4 week test is largely to make sure the drug is working. It's preferable to see at least a 2-log decrease, and mine was a 5-log, w/ very normal liver enzyme numbers for the first time since this journey began. So, a good report, just not a "perfect" one. The 12-wk post EOT is 'THE" test where we need to see that magic word, but if it pops up sooner, so much the better! I just passed my 6-wk mark and am looking forward to my labs at 8 weeks, and hopefully seeing that word. We need to focus on getting to the other side -- SVR and try not to stress about it. Hope this helps,  FT
Treatment naive
Likely contracted mid-70s
Diagnosed 1a, 2011
F1-2
Harvoni X 12 weeks, completed 5/17/16
Pre-treatment: VL 3 mil, AST 64, ALT 84
4 week labs: VL 30, AST 21, ALT 14
8 week labs: VL UD!!!, AST 22, ALT 16
12 week labs: VL UD, AST 23, ALT 14
2 wk EOT: VL UD
12 wk EOT: VL UD, AST 22, ALT 13 =  SVR 12! Yay! 
Last hep appointment: VL UD, AST 19, ALT 12 = SVR 39! I AM DONE!

Offline Hepsub

  • Member
  • Posts: 32
  • bahamas in 12 days to detox from Suboxone+Clonopin
Re: 4 week viral load
« Reply #6 on: April 07, 2016, 05:17:37 pm »
Bri,

My viral load was only 100k to start. I am participating in a clinical trial where my titer results were available hourly on the first day, week 1, week 2, week 4, week 8 and then 12. After the first day i experienced a precipitous decline from 100k all the way down to 300. By week two i was under the lower limit of quantification (just means its there but they can't precisely measure it) and was obviously anxiously anticipated seeing that coveted "undetected" reading by week 4.  Much to my dismay, the week 4 test revealed the same as week 2. I began to panic, mistook treatment symptoms and other stressors for the return or rebound of the virus and nearly drove myself insane for a week with paranoia.  After resigning to the notion that i had no control over the outcome, i returned reinvigorated to my quest to de stress as much as possible and explore every avenue possible to allow my body to properly detox.  Around week 6 i could feel my body turning the corner, and now at week 9 i can happily share that I am undetected! So take heart and try to relax as much as possible (doing this systematically can help: ask me if your unfamiliar with the formal practice and i can make some recommendations to you).. The odds are in your favor....

PZ
Diagnosed 2014 Viral Load 108,000
Treatment Vpak w/ Riba Weight Based 12 weeks
Viral Loads:
Day 1 Hour 1= 95989
Hour 2=100,805
Hour 4=10681
Hour6=1487
Hour 8=809
Day 2=101
Day 3=45
Day4=23
Day 5=21
Week 1= 14
Week 2= <12
Week 4= <12
Week 8= Undetected
Week 12 (EOT, ~12 hours after last dose)= Undetected
Week 15- Rash From Pre tx returns, viral illness symptoms manifest.. Please lord No......

Offline brie41

  • Member
  • Posts: 191
Re: 4 week viral load
« Reply #7 on: April 07, 2016, 05:58:25 pm »
Hi FT and Hepsub,

  Thanks for your replies.  I know I am just getting anxious because I am doing only 8 weeks.  I will take your words to heart and stop sweating the small stuff.  Feeling so much like myself now I almost forget that there is a war being waged inside me!!  Amazing drug for sure!!  Be well! Brie
Diagnosed  HCV, 1A 2006
Viral load 6 million
Ast/Alt always in the 20's
F0-F1, never changed
Treatment naive, started 8 week Harvoni 3/15/16
4 and 8 week labs undetected
6 week eot labs undetected
13 week eot UNDETECTED!

Offline dragonslayer

  • Member
  • Posts: 873
Re: 4 week viral load
« Reply #8 on: April 07, 2016, 11:25:45 pm »
Hi Brie,

Not only was I detected at EOT, but even 8 wks post treatment.  And still, I cleared by 12 wks  post and am SVR...

On treatment testing with these new drugs is essentially meaningless.    The only tests that are really probative are those done post treatment.  Dont fret about any on-treatment results.
Paul

DX 2008
Started Harvoni 11/26/14 for 8 wks
Completed 8 wks Harvoni 01/20/15
EOT RNA Quant result:  Detected 29
7.5 wk post tx: Detected < LLOQ(12)
11 wk post tx: UNDETECTED SVR12
24 wk post tx: UNDETECTED SVR24; AST 26; ALT 22; ALP 73
48 wk post tx: UNDETECTED SVR48; AST 18; ALT 18; ALP 70
GT 1a
vl 2.4mil
2008 bpx: Stage&Grade 0
2013 bpx: Stage&Grade: 0-1
IL28B: TT
likely infected early '70s

Offline kimlav

  • Member
  • Posts: 24
Re: 4 week viral load
« Reply #9 on: April 08, 2016, 11:19:22 am »
Hi Brie,

I am feeling the same anxiety as you are.  I just finished 8 weeks Harvoni on March 16 and had only one viral load which was done the day after EOT on March 17. The nurse called me and told me I was undetected. I am quite anal and I wanted the exact numbers and was told it was <12.  I see some people have results of <15 and wonder what the difference is. (I think different testing methods). So at first I was delighted and then somewhat disappointed. I have even started thinking about a "relapse plan" so I wouldn't be so mentally devastated if it should happen because hope can be a terrible thing, especially for all of us who have waited so long for a cure.

About the 5% chance - I lived in mortal terror for 10 years that I gave hep c to my 2 kids to the point that I couldn't even bring myself to get them tested. Finally, I had no choice or have a mental breakdown and it turns out that neither of them even have the antibodies despite having a 5% chance of having it. (They were both c sections so that made the odds a little better but I breastfed them both for a year each). I didn't know I was infected when I got pregnant (as I likely would not have had children had I known) and learned I had it when my eldest child was 9.

Now I have a 5% chance of relapsing on Harvoni and that 5% is as big to me in this case as it was when I thought my kids could have it.

In any event, I have saved Dragonslayer's and Katie's stats as a screenshot and look at them often for hope and reassurance. So thank you to everyone who posts on this forum with their knowledge and experience.

Good luck Brie. I am crossing my fingers for all of us out here in "hurry up and wait for results mode". My hep c nurse told me that waiting for the results is thought to be the most difficult part of treatment. I agree.

Kim
52 year old female
Geno 1a
Contracted in the 80's
Tx naive
vl 657,000 in Nov/15
No liver damage
ALT prior to tx: 107, 91 - 41 at 2 wks, 38 at 4 wks
AST prior to tx: 59,72 - 45 at 2 wks, 37 at 4 wks
started 8 wks Harvoni on Jan 21/16
EOT vl <12 detected
4.5 wk EOT vl - target not detected! RNA Not detected!
12 wk EOT vl - target not detected! (Will never get tired of typing that)
24 wk EOT vl -  not detected

Offline FutureThinker

  • Member
  • Posts: 711
  • Onward and upward!
Re: 4 week viral load
« Reply #10 on: April 08, 2016, 01:22:46 pm »
Dragonslayer, thanks very much for your info, means a lot to those of us who are still in the "early" stages of winning this war.  After my 4 wk lab of 30IU, after a day or 2 I realized there was nothing I could do except keep taking my pill every day, eat healthy, get my exercise, stay hydrated, and keep my stress as low as possible.  That's all we can do. We just need to stay positive and focus on that goal of SVR -- "stay calm and carry on".  FT
Treatment naive
Likely contracted mid-70s
Diagnosed 1a, 2011
F1-2
Harvoni X 12 weeks, completed 5/17/16
Pre-treatment: VL 3 mil, AST 64, ALT 84
4 week labs: VL 30, AST 21, ALT 14
8 week labs: VL UD!!!, AST 22, ALT 16
12 week labs: VL UD, AST 23, ALT 14
2 wk EOT: VL UD
12 wk EOT: VL UD, AST 22, ALT 13 =  SVR 12! Yay! 
Last hep appointment: VL UD, AST 19, ALT 12 = SVR 39! I AM DONE!

Offline brie41

  • Member
  • Posts: 191
Re: 4 week viral load
« Reply #11 on: April 08, 2016, 07:47:21 pm »
Hi Dragonslayer,

 That is so great that you went on to svr!  I will not stress at this point!!  Thank you. 

Kimlav,

 I can only say I think we have much in common.  I had no idea that I had hcv and found out when my son was 7.   I didn't think I was at risk for it and I remember almost an out of body experience at the Doctors office and am not sure how I drove home that day.  I was consumed with anxiety about my Son and Husband and of course i thought of everyone else that I was sure I might have infected.  I did have them tested right away and thankfully they were both negative.  I breathed a major sigh of relief and then started researching  and going on message boards right away.  The message boards saved me for sure.  I thought for sure I had serious liver damage as that is why I was having tests run when I found out.  To my surprise I was between f0-f1 and have stayed that way.   I have a friend who has hcv and decided to not have her kids tested.  It is a personal choice but I know I would have gone out of my mind had I not done it.  Trust me, I understand you going with the odds that they are just fine.  I wish you the best of luck and just keep visualizing good results!!!  Brie
Diagnosed  HCV, 1A 2006
Viral load 6 million
Ast/Alt always in the 20's
F0-F1, never changed
Treatment naive, started 8 week Harvoni 3/15/16
4 and 8 week labs undetected
6 week eot labs undetected
13 week eot UNDETECTED!

Offline Forest dweller

  • Member
  • Posts: 27
Re: 4 week viral load
« Reply #12 on: April 14, 2016, 07:17:38 pm »
HI Brie et al...

Just got my Vl back four weeks...alt down to 16, and Vl down 5 logs...
DOES ANYONE KNOW WHAT THAT MEANS????
I was over 6 million Vl when starting..
Any answer would be great, as I don't see doc for two weeks.
Thanks

Forest dweller

Offline Lynn K

  • Global Moderator
  • Member
  • Posts: 4,543
  • Get tested, get treated, get cured, fight Hep c!
Re: 4 week viral load
« Reply #13 on: April 14, 2016, 09:35:55 pm »
Decrease in ALT and/or AST means your liver in no longer under attack by the hep c virus.

A decrease in viral load means there is less hep c circulating in your blood. Do you know what your new viral load number is?

What you are looking to see is 12 weeks after treatment is completed is not detected.

On treatment viral load testing means little except to check patient compliance.

Good luck
Lynn
Genotype 1a
1978 contracted, 1990 Dx
1995 Intron A failed
2001 Interferon Riba null response
2003 Pegintron Riba trial med null response
2008 F4 Cirrhosis Bx
2014 12 week Sov/Oly relapse
10/14 fibroscan 27 PLT 96
2014 24 weeks Harvoni 15 weeks Riba
5/4/15 EOT not detected, ALT 21, AST 20
4 week post not detected, ALT 26, AST 28
12 week post NOT DETECTED (07/27/15)
ALT 29, AST 27 PLT 92
24 week post NOT DETECTED! (10/19/15)
44 weeks (3/11/16)  fibroscan 33, PLT 111, HCV NOT DETECTED!
I AM FREE!

Offline brie41

  • Member
  • Posts: 191
Re: 4 week viral load
« Reply #14 on: April 28, 2016, 10:57:38 am »
Hi Everyone,

  I can happily report that I am undetected as of week 4!   Thank you all for getting me this far.  I was a bit of a wreck, and still a bit nervous about only doing 8 weeks, but I will go with the odds and hope for the best!!  Yeah!  Brie
Diagnosed  HCV, 1A 2006
Viral load 6 million
Ast/Alt always in the 20's
F0-F1, never changed
Treatment naive, started 8 week Harvoni 3/15/16
4 and 8 week labs undetected
6 week eot labs undetected
13 week eot UNDETECTED!

Offline jakas

  • Member
  • Posts: 265
Re: 4 week viral load
« Reply #15 on: April 28, 2016, 11:58:25 am »
Excellent !!!! :D
M/57 yrs.
Contracted (Unknown) 10-20-30 yrs back ??
Treatment Naive
Geno 1a&1b
VL  17+ million
ALT 200+, AST 170+
Fibroscan F4 ( 26+ kpa ) on 8th Dec. 2105
Started Tx 11th Dec.2015 ( 12 wks. Gilead Harvoni)
7/1/2016 :Viral Load|<25 UND.
23/1/2016: ALT 34 , AST 35, ALP 143
8 week NO labs done
EOT:03.03.2016 ( 84 pills eaten )
ALT 26, ALP 124, BIL .54
V/L <25 UND E.O.T.
4 weeks E.O.T. V/L UND::: SVR 4
SVR 12 and  SVR 24 on 16/8/16
Fibro 24.5kpa 23/05/16
SVR 63 05/17
Fibro 17.03.2020 kpa 6.3

Offline Hepsub

  • Member
  • Posts: 32
  • bahamas in 12 days to detox from Suboxone+Clonopin
Re: 4 week viral load
« Reply #16 on: April 28, 2016, 01:57:21 pm »
congrats brie... now you can relax and enjoy the security and work on ensuring you retain it in perpetuity! :) i should be getting my week 12 viral titer back tomorrow so I've gone from confidence to nervousness once again lol.. i suspect it doesn't end until SVR 12... good luck!
Diagnosed 2014 Viral Load 108,000
Treatment Vpak w/ Riba Weight Based 12 weeks
Viral Loads:
Day 1 Hour 1= 95989
Hour 2=100,805
Hour 4=10681
Hour6=1487
Hour 8=809
Day 2=101
Day 3=45
Day4=23
Day 5=21
Week 1= 14
Week 2= <12
Week 4= <12
Week 8= Undetected
Week 12 (EOT, ~12 hours after last dose)= Undetected
Week 15- Rash From Pre tx returns, viral illness symptoms manifest.. Please lord No......

Offline brie41

  • Member
  • Posts: 191
Re: 4 week viral load
« Reply #17 on: April 28, 2016, 03:24:50 pm »
Thank you!  Good luck tomorrow Hepsub!!  It is a roller coaster for sure.   
Diagnosed  HCV, 1A 2006
Viral load 6 million
Ast/Alt always in the 20's
F0-F1, never changed
Treatment naive, started 8 week Harvoni 3/15/16
4 and 8 week labs undetected
6 week eot labs undetected
13 week eot UNDETECTED!

 


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